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PROFMED BENEFITS AND NEW CHANGES FOR 2013

PROFMED BENEFITS AND NEW CHANGES FOR 2013. Carin Swanepoel. HISTORY/DEMOGRAPHICS. Profmed was established in 1959 and registered in 1960 Serves 64 000 lives Restricted medical scheme Healthy Professional risk pool. PROFMED SCHEME DEMOGRAPHICS AS AT 2012. SOLVENCY 40+/-%

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PROFMED BENEFITS AND NEW CHANGES FOR 2013

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  1. PROFMED BENEFITS AND NEW CHANGES FOR 2013 Carin Swanepoel

  2. HISTORY/DEMOGRAPHICS • Profmed was established in 1959 and registered in 1960 • Serves 64 000 lives • Restricted medical scheme • Healthy Professional risk pool

  3. PROFMED SCHEME DEMOGRAPHICS AS AT 2012 • SOLVENCY 40+/-% • PRINCIPAL MEMBERS 26800 • AVG CONTRIBUTION INCREASE FOR 2013 8.59% • GLOBAL CREDIT RATING AA-

  4. BENEFIT OPTIONS

  5. PROPINNACLE In Hospital Benefits • Unlimited Cover • 300% of Profmed Tariff • Surgery & In-hospital procedures • Consultations in hospital • Private Ward

  6. PROPINNACLE Chronic Medication • Unlimited cover • 58 chronic conditions

  7. PROPINNACLE Out of Hospital Benefits • 100% of Profmed Tariff • GP & Specialist consultations • Procedures in Doctor’s rooms

  8. PROPINNACLE Out of Hospital Benefits • Day-to-day benefits • Pooled benefit • 100% of Profmed tariff • M R13 000 - R 13 500 • M+1 R19 500 - R 20 000 • Max R26 000 - R 26 000 per family

  9. PROSECURE PLUS In Hospital Benefits • Unlimited Cover • 300% of Profmed Tariff – 2013 Profmed Tariff 200% • Surgery & In-hospital procedures • Consultations in hospital

  10. PROSECURE/ PROSECURE PLUS Chronic Medication • M R12 000 • M+1 R20 400 • Family R27 000 • 38 chronic conditions - Unlimited

  11. PROACTIVE PLUS In Hospital Benefits • Unlimited Cover • 300% of Profmed Tariff - 2013 Profmed Tariff 200% • Surgery & In-hospital procedures • Consultations in hospital • 26 PMB’s

  12. PROACTIVE In Hospital Benefits • Unlimited Cover • 100% of Profmed Tariff • Surgery & In-hospital procedures • Consultations in hospital • 26 PMB’s

  13. Profmed Benefit Philosophy • There when our members needs us • Unlimited hospital cover on all options • No co-payments or deposits paid in hospital • In-hospital dental cover on both ProActive options • Preventative care benefits on all options • Oral contraceptives on all options • Trauma an post HIV exposure assistance on all options

  14. New Benefit for 2013 • HPV Vaccine • International Travel • Dental Benefit

  15. Contribution Increase for 2013 Average Increase (member weighted) – 8.59% • ProActive 7.94% • ProActive Plus 8.10% • ProSecure 9.42% • ProSecure Plus 9.28% • ProPinnacle 9.26%

  16. CONTRIBUTIONS R0-R3000 MONTHLY INCOME

  17. CONTRIBUTIONS R3001-R6 000 MONTHLY INCOME

  18. CONTRIBUTIONS R6 000 + MONTHLY INCOME

  19. PREVENTATIVE CARE • Early detection of high risk • Testing for particular diseases • Facilitates early treatment – maximise outcome • Influenza vaccine • Oral contraceptives • Human papillomavirus (HPV) vaccine

  20. PROFMED WELLNESS • Profmed partnered with Multiply to provide members with a lifestyle program to maximise health care • Some of the benefits include: • Online wellness profile to assess your health status • Lower fees for fitness assessments • Discounted gym fees • Discount on selected nutritional supplements • Up to 50% reduction on flights. • Other rich discounts on lifestyle products

  21. THANK YOU

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